Molecular model of heroin.

What are harm reduction strategies for heroin use?

Never use alone.

There are several important harm reduction strategies for people who use heroin.

Use sterile and new equipment.

Heroin can be injected, smoked, or snorted. When possible, people who use heroin should use sterile and new equipment every time. Supplies may include syringes, cookers, pipes, and straws. People should also avoid sharing equipment with others. Reusing or sharing equipment can place users at risk of skin and soft tissue infections, and spread diseases like HIV and Hepatitis C.

Never use alone.

People should avoid using heroin alone. They should make sure that someone has naloxone (the opioid reversal medication) on hand in case of an overdose.

Check drugs if possible.

People also should use fentanyl test strips or other available drug checking technologies to test their heroin for other adulterants. Fentanyl test strips are often available at harm reduction programs, and can tell someone whether or not fentanyl is present. However, they cannot tell someone how much fentanyl is present.

Go slow.

People should “go slow,” dilute their drugs, or take a little bit at a time to reduce the risk of an overdose by accidentally taking too much. It is also advised that people do not take heroin in combination with other opioids or depressant drugs, including alcohol. This can increase the risk of an overdose.

We need a health approach to heroin.

The risk of heroin use has increased with additives in the drug supply like fentanyl. Learn more about how drug decriminalization and investing in health, overdose prevention centers, and safer supply can keep people safer.

Reviewed and updated by Jules Netherland, PhD, and Dr. Sheila P. Vakharia on 5/2/2023.

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